Pain relief options range from self-help techniques like breathing and movement, through TENS machines and gas and air, to pethidine, epidurals, and water birth. There is no single right approach. Your birth plan can include preferences that you adjust as labour progresses.
These are available everywhere and have no side effects. They are most effective in early labour and can be used alongside other methods.
Breathing techniques. Slow, rhythmic breathing helps you stay calm and manage contractions. The simplest approach is breathing in slowly through your nose and out through your mouth, focusing on making the out-breath longer than the in-breath.
Movement and positioning. Staying upright and mobile can help labour progress and reduce pain. Rocking on a birth ball, leaning forward over a bed or chair, walking, swaying, and going on all fours are all positions people find helpful.
Massage and counterpressure. Firm pressure on your lower back during contractions can provide significant relief, especially if you are experiencing back labour.
Warm water. A warm bath or shower can ease pain and help you relax. Many hospitals have baths on the labour ward specifically for this purpose.
A TENS machine sends small electrical pulses through pads stuck to your back. You control the intensity with a handheld unit. It works by stimulating your body to produce endorphins and by interrupting pain signals.
TENS is most effective when started in early labour and built up gradually. You will need to bring your own, as most hospitals do not provide them. They cannot be used in water.
Entonox is a mix of nitrous oxide and oxygen that you breathe through a mouthpiece. You hold the mouthpiece yourself and breathe it in as a contraction builds, then stop between contractions.
Gas and air does not remove pain entirely. Most people describe it as taking the edge off. It can make you feel lightheaded or slightly nauseous. These effects wear off within minutes of stopping. It is available on all labour wards and has no lasting side effects for you or the baby.
These are opioid painkillers given as an injection into your thigh or buttock. They take around 20 to 30 minutes to work and the effects last 2 to 4 hours. They do not remove pain completely but can help you relax and cope between contractions. Common side effects include drowsiness and nausea.
If given too close to delivery, opioids can temporarily affect the baby's breathing and feeding. Your midwife will consider timing carefully.
An epidural is the most effective form of pain relief in labour. An anaesthetist inserts a thin tube into the space near your spinal nerves in your lower back. Local anaesthetic is delivered through this tube, numbing the nerves that carry pain signals.
Most people experience significant or complete pain relief. The procedure takes about 20 minutes to set up. You will need continuous monitoring and a drip in your arm. Your mobility will be limited.
Possible side effects include a drop in blood pressure, difficulty feeling the urge to push, headache after delivery in rare cases, and a slightly longer second stage. Epidurals are only available on hospital labour wards. An epidural does not increase the risk of long-term back pain.
Some hospitals offer remifentanil, a very short-acting opioid delivered through a patient-controlled pump. You press a button as a contraction starts and the drug works within seconds. It requires one-to-one midwifery care and continuous monitoring. Not all hospitals offer it.
Giving birth in a pool of warm water provides natural pain relief and buoyancy. Water birth is suitable for people with straightforward, low-risk pregnancies. You cannot use a TENS machine in the pool, but you can use gas and air.
You do not need to decide everything in advance. There is no medal for refusing pain relief, and there is no failure in asking for it. The best birth is one where you feel safe, supported, and informed.
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